Mortality among children with disabilities: a systematic review and meta-analysis
1
Physiotherapy, Stellenbosch University, Cape Town, South Africa
2
London school of Hygiene and Tropical Medicine, London, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
There is a 14-year life expectancy gap between people with and those without disabilities. We aimed to synthesise evidence on all-cause mortality among children with disabilities compared to their non-disabled peers through a systematic review and meta-analysis.
METHODS:
This review was prospectively registered in PROSPERO (CRD420251072039). We searched Embase, Global Health, MEDLINE, PubMed and PsycInfo databases for relevant studies published between January 1, 2000 to November 3, 2025. We included cohort studies that compared all-cause mortality rates for children (aged 0-19) with and without disabilities. We excluded studies lacking a clear disability definition, disaggregated mortality data, or an appropriate control group. Two authors independently screened studies, while data extraction was done by one and verified by a second. We used the JBI tool to assess the risk of bias and conducted meta-analyses in RevMan for studies reporting age-adjusted or multivariable-adjusted mortality rates.
RESULTS:
We identified 10,829 records of which 26 studies met the inclusion criteria, representing over 33 million children. The included studies represented most world regions with many studies drawing from national databases/registries (n=18; 69%). All 26 studies had a low risk of bias (JBI critical appraisal score > 8). Overall, children with disabilities had a five-fold higher all-cause mortality rate than their peers (HR=5·33, 95%CI: 3·58 – 7·91). Mortality was higher in both younger children under 5 (HR=7·51, 95%CI:4·70 -12·00) and children 6 -19 years (HR=4·68, 95%CI:2·26 - 9·69). Mortality by disability type was most evident for children with neurological disabilities (HR=11·71, 95%CI: 7·90 – 17·35).
CONCLUSIONS:
Children with disability have a higher mortality rate than their non-disabled peers. Under-five mortality is a key global health priority but has not yet achieved sufficient results for children with disabilities. Therefore, this should be a target population within global efforts to reduce child mortality.
There is a 14-year life expectancy gap between people with and those without disabilities. We aimed to synthesise evidence on all-cause mortality among children with disabilities compared to their non-disabled peers through a systematic review and meta-analysis.
METHODS:
This review was prospectively registered in PROSPERO (CRD420251072039). We searched Embase, Global Health, MEDLINE, PubMed and PsycInfo databases for relevant studies published between January 1, 2000 to November 3, 2025. We included cohort studies that compared all-cause mortality rates for children (aged 0-19) with and without disabilities. We excluded studies lacking a clear disability definition, disaggregated mortality data, or an appropriate control group. Two authors independently screened studies, while data extraction was done by one and verified by a second. We used the JBI tool to assess the risk of bias and conducted meta-analyses in RevMan for studies reporting age-adjusted or multivariable-adjusted mortality rates.
RESULTS:
We identified 10,829 records of which 26 studies met the inclusion criteria, representing over 33 million children. The included studies represented most world regions with many studies drawing from national databases/registries (n=18; 69%). All 26 studies had a low risk of bias (JBI critical appraisal score > 8). Overall, children with disabilities had a five-fold higher all-cause mortality rate than their peers (HR=5·33, 95%CI: 3·58 – 7·91). Mortality was higher in both younger children under 5 (HR=7·51, 95%CI:4·70 -12·00) and children 6 -19 years (HR=4·68, 95%CI:2·26 - 9·69). Mortality by disability type was most evident for children with neurological disabilities (HR=11·71, 95%CI: 7·90 – 17·35).
CONCLUSIONS:
Children with disability have a higher mortality rate than their non-disabled peers. Under-five mortality is a key global health priority but has not yet achieved sufficient results for children with disabilities. Therefore, this should be a target population within global efforts to reduce child mortality.
| eISSN: | 2654-1459 |
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